Business of Being Born: Classroom Edition

Childbirth is a women’s rights issue and a reproductive justice issue. The United States maternity system is one of the costliest in the developed world, yet our birth outcomes compare poorly to those of other industrialized nations. Among industrialized countries, we consistently rank last or second to last in perinatal and maternal mortality rates. Moreover, birth is depicted in mainstream media with fear, medical intervention, and crisis…

It took me some time to get around to it, but I’ve finally finished exploring The Business of Being Born: Classroom Edition and its associated toolkit of educational materials! As a long-time childbirth educator and birth activist, of course I was interested in this classroom version of the (new) classic birth advocacy film, but I’m also a college professor and therefore was doubly interested—how might this resource be incorporated into one or more of my human services courses? As the BoBB companion site explains…

Childbirth is an issue most people do not engage with until they have experienced the maternal health system. The Business of Being Born: Classroom Edition reaches out to young adults BEFORE they confront their own birth decisions, both placing the issue on the radar and challenging the prevailing assumptions about birth providers and current obstetrical management trends. The goal is for the next generation of policy makers, practitioners, educators, and parents to approach birth decisions with awareness and confidence. Our strategy is to incorporate this evidence-based presentation into classrooms around the country. We envision empowering the next generation of parents to seek out systemic change and new policies supporting domestic maternity care…

The Classroom Edition of the film runs about 25 minutes and comes packaged with one of my all-time favorite resources for birth classes and tabling events: The Guide to a Healthy Birth from Choices in Childbirth. It also comes with two additional celebrity interviews, the short film Birth by the Numbers, and a instructor’s toolkit with classroom activities tying the themes of the film to major subjects such as Women’s Studies, Public Health, and Sociology.

My only critique of the classroom edition of the film is that the assembled quotes at the beginning of the film are put together in a choppy sort of way that makes it difficult to perceive (for the average viewer), which are the “good” (i.e. accurate) quotes and which are popular types of misinformation. There is also an odd, repetitively distracting, monotonal quality to the music that plays through much of the footage. Excerpted from the full-length film, the classroom edition still includes Ricki Lake’s homebirth in her bathtub, which was one of my top favorite moments of the original film. Content from a historical perspective as well as content involving the shadowing of a homebirth midwife and the personal stories from families choosing midwifery care were greatly reduced from the original version and the classroom edition seems to have more of an emphasis on sociocultural analysis. It is noted that 90% of women in many hospitals experience some type of labor augmentation (usually pitocin) and also that hospitals are businesses, businesses that are not really interested in having women hang around in the labor room.

One of the college courses I teach is American Social Policy. I have always been interested in birth change from a systemic (macro) level as a companion to change on the individual (micro) level, so I especially appreciated watching the Birth by the Numbers presentation included with the classroom edition of BoBB. When speaking about the idea that the increase in cesarean rate reflects maternal choice, public health professor Gene Declercq says, “this blaming of women is farcical. It is not about the mothers, it is about the way we treat care in the United States. Nobody ever wants to admit there is a difficult inherent in the system.” Well, I want to admit it and this is the kind of macrosystem-level change we talk about in my Policy course. At the companion Birth by the Numbers website, you can download a powerpoint presentation and other teaching tools, as well as watch the short film, in which public health professor Gene Declercq debunks popular myths about the causes of the United States cesarean rate increase. The film also looks at disparities in maternity mortality rates and tackles questions of systemic influences on maternal health outcomes.

So, are mothers really asking for cesareans?

Declercq also draws on writing from the classic obstetrics textbook, Williams Obstetrics, and shares this quote about one of the real reasons that cesarean rates continue to rise:And, he makes this important observation:
As Nadine Goodman says in The Business of Being Born Classroom Edition, “A woman will always remember how she was made to feel during her birth…if you don’t have the reverence and respect for birth, where do you go from here?”

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